Physiomobile - Physiotherapy Malaysia

POST COVID - 19 REHABILITATION

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. The virus can spread from an infected person’s mouth or nose in small liquid particles when they cough, sneeze, speak, sing or breathe.

World Health Organization :

Post COVID rehabilitation comprises a multidisciplinary team led by a Rehabilitation Physician
The team is made up of physiotherapists, occupational therapists, speech and language
Therapists, psychologists, nurses, dieticians and pharmacists
Every member plays a role in looking at the multisystem impairment; with patient-centered goals

Aim :

Improve fitness
Reduce breathlessness
Increase muscle strength
Improve balance and coordination

Improve thinking
Reduce stress and improve mood
Increase confidence
Improve energy

Sign & symptoms :

The five most commonly reported symptoms were :

Fatigue
Exertional dyspnoea
Insomnia
Cough
Anxiety
Impaired lung function

Severe muscle weakness
Joint stiffness
Limited mobility and ability to do daily tasks
Delirium and other cognitive impairments
Difficulty swallowing and communicating
Mental health disorders and psychosocial support needs

POST COVID - 19 REHABILITATION risk Factors

Older Age - People of any age can catch COVID-19. But it most commonly affects middle-aged and older adults. The risk of developing dangerous symptoms increases with age, with those who are age 85 and older are at the highest risk of serious symptoms
Lung Problems, including asthma - Besides being an asthma trigger, smoking or vaping can harm your lungs and inhibit your immune system, which increases the risk of serious complications with COVID-19
Heart Disease - If you have high blood pressure, your risk may be higher if you don't control your blood pressure and take your medications as directed

Diabetes and Obesity - Diabetes and obesity both reduce how well a person's immune system works. Diabetes increases the risk of infections in general
Chronic Kidney or Liver Disease - Chronic kidney or liver disease can weaken your immune system, which may increase your risk of being seriously ill with COVID-19. Also, having serious COVID-19 symptoms and taking medications to treat the disease may have negative effects on the liver
Mental Health Condition - People with mental health conditions such as depression and schizophrenia spectrum disorders may be more likely to develop serious COVID-19 symptoms

POST COVID - 19 REHABILITATION treatment

1. Manual Therapy for airway clearance : Aimed at loosening retained secretions from the airway walls :
- Chest clapping / Percussion - Performed using a cupped hand with a rhythmical flexion and extension action of the wrist
- Chest shaking - Course oscillations produced by the therapist’s hands compressing and releasing the chest wall.This technique augments expiratory flow and may help to mobilize secretion
- Chest vibration - Fine oscillations applied to the chest wall by the therapist’s hands or fingertips (in babies).This technique augments expiratory flow and may help to mobilize secretion
2. Strengthening and endurance exercise - During rehabilitation after a Covid-19 it is important to try to maintain cardiovascular endurance and strength

3. Breathing exercise :
- Diaphragmatic Breathing :
  - The patient sits in a comfortable, relaxed and supported position
  - One hand is placed on the chest while the other is on the abdomen
  - The patient is asked to breathe in slowly through the nose and then to breathe out through the nose
  - With each breath, the patient should appreciate the hand over the abdomen rising more than the hand over the chest
  - The patient is advised to use as little effort as possible and to ensure breaths are slow, relaxed, and smooth
  - Perform __repetitions per set and do __sets per day

- Thoracic Mobility Exercise (TME) / Thoracic expansion exercise (TEE) :
  - The patient sits in a comfortable, relaxed and supported position
  - The patient slowly takes a deep breath while raising his arms towards the ceiling.
  - The patient is then instructed to hold his breath for 3 seconds
  - The arms are slowly brought down to the lap while breathing out through the mouth with a pursed lip
  - Perform__ repetitions per set and do __sets per day
- Pursed Lips Breathing :
  - The patient sits in a comfortable, relaxed and supported position
  - Ensure that the neck and shoulder muscles are relaxed
  - The patient breathes in through the nose slowly for 2 counts, while keeping the mouth closed
  - The lips are pursed as if about to whistle or gently flicker the flame of a candle

- - The patient is then asked to breathe out slowly through pursed lips while counting to 4
  - This technique may be used in combination with the symptom relieving postures to ease dyspnoea
  - Perform__ repetitions per set and do __sets per day
- Huffing Technique :
  - Huffing technique is a cycle of deep breathing, thoracic expansion and huff with the purpose of airway clearance
  - Huffing occurs through forced expiration with an open mouth
  - A huff is an active breath out with an open throat, like a sigh, as if trying to fog up a mirror
  - The patient is asked to perform a sequence of 23 deep breaths then 12 huffs, followed by a cough to clear any sputum
  - Perform__ repetitions per set and do __sets per day

POST COVID - 19 REHABILITATION

POST COVID - 19 REHABILITATION risk Factors

POST COVID - 19 REHABILITATION treatment

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